Family Life and Reproductive Health Education

Family Life and Reproductive
Health Education
Dr Simon Boateng
Sexual and Reproductive Health: Historical Overview
• Sexual and reproductive health was first defined at the International
Conference on Population and Development (ICPD), held in Cairo in
1994.
• The term ‘reproductive health’ reflected a sharp departure from

previous approaches to the question of how, and to what extent,
humans reproduce.
Sexual and Reproductive Health: Historical Overview Cont’d
• In reaction to the often-aggressive population control programs
launched in the 1960s and 1970s in Africa, Asia, and Latin America,
the international women's movement and others called for programs
that would both respect women's human rights and provide them with
services for a range of issues beyond just birth control – going
through childbirth safely, having a healthy, wanted child, and being
free from sexually transmitted infections (STIs).
• The definition of reproductive health also pointed to the
central importance of human sexual relationships, and the fact
that they often represent an unequal exchange between people,
and particularly between women and men.
• This inequality, rooted in societies' views of gender, plays a

critical role in sexual and reproductive health.
• The concept ‘gender’ is defined as encompassing the different roles, rights,
expectations, and obligations that culture and society attach to individuals on the
basis of their sex.
• Sex refers to the anatomy of an individual's reproductive system and secondary

sex characteristics, often categorized as male or female, but it is important to
note that sex is not a binary category.
• Gender, on the other hand, concerns categories

of masculinity and femininity that are learned through socialization and that are
subject to change over time.
• In most societies, there are differences
and inequalities between women and men in responsibilities
assigned, activities undertaken, access to and control over
resources, as well as decision-making opportunities, all of
which have an impact on, and are affected by, sexual and
reproductive health (WHO, 2015a; UN Women, 2015).
What is Reproductive Health
• Reproductive health is a state of complete physical, psycho-
emotional and social well-being, (but not merely the absence
of disease or infirmity), in all matters relating to the
reproductive system and to its functions and processes.
• Reproductive health, therefore, implies that people are able

to have a satisfying and safe sex life and that they have the
capability to reproduce and the freedom to decide if, when
and how often to do so.
What is Reproductive Health Cont’d
• To maintain one’s sexual and reproductive health, people need access
to accurate information and the safe, effective, affordable and
acceptable contraception method of their choice.
• They must be informed and empowered to protect themselves from

sexually transmitted infections.
• And when they decide to have children, women must have access to
services that can help them have a fit pregnancy, safe delivery and
healthy baby.
What is Reproductive Health Cont’d
• Every individual has the right to make their own choices about their
sexual and reproductive health.
• UNFPA, together with a wide range of partners, works toward the goal
of universal access to sexual and reproductive health and rights,
including family planning.
Reproductive health and development related issues
• UNFPA works to ensure sexual and reproductive health and rights remain at the
very centre of development.
• The International Conference on Population and Development draws a clear

connection between reproductive health, human rights and sustainable
development.
• When sexual and reproductive health needs are not met, individuals are deprived
of the right to make crucial choices about their own bodies and futures, with a
cascading impact on their families’ welfare and future generations.
• And because women bear children, and also often bear the
responsibility for nurturing them, sexual and reproductive
health and rights issues cannot be separated from
gender equality.
• Cumulatively, the denial of these rights exacerbates poverty

and gender inequality.
Key Concerns about Reproductive Health
• Reproductive health problems are a leading cause of ill health
and death for women and girls of childbearing age.
• Impoverished women suffer disproportionately from

unintended pregnancies, unsafe abortion, maternal death and
disability, sexually transmitted infections (STIs), gender-based
violence, and other related problems.
• Young people are also extremely vulnerable, often facing barriers to
sexual and reproductive health information and care.
• Young people are disproportionately affected by HIV, for example, and

every year millions of girls face unintended pregnancies, exposing
them to risks during childbirth or unsafe abortions and interfering with
their ability to go to school.
• Adolescent reproductive health is therefore another important focus of

UNFPA’s work.
• UNFPA also works to prevent and address STIs, which take an
enormous toll around the world. More than a million people acquire an
STI every single day.
• Without diagnosis and treatment, some STIs, such as HIV or syphilis,

can be fatal. STIs can also cause pregnancy-related complications,
including stillbirth, congenital infections, sepsis and neonatal death.
• STIs like human papillomavirus (HPV) can lead to pelvic

inflammatory disease, infertility and cervical cancer, a major killer of
women.
A life cycle approach
• Reproductive health is a lifetime concern for both women and men,
from infancy to old age.
• Evidence shows that reproductive health in any of these life stages has
a profound effect on one's health later in life.
• UNFPA supports programmes tailored to the different challenges

people face at different times in their lives, including comprehensive
sexuality education, family planning, antenatal and safe delivery care,
post-natal care, services to prevent sexually transmitted infections
(including HIV), and services facilitating early diagnosis and treatment
of reproductive health illnesses (including breast and cervical cancer).
A life cycle approach Cont’d
• To support reproductive health throughout the life cycle,
services across a variety of sectors must be strengthened,
from health and education systems to even transport
systems – which are required to ensure health care is
accessible.
• And all efforts to support sexual and reproductive health

rely on the availability of essential health supplies, such
as contraceptives, life-saving medicines and basic
medical equipment.
The Human Reproductive Systems
• Reproductive health refers to the condition of male and female
reproductive systems during all life stages. These systems are
made of organs and hormone-producing glands, including the
pituitary gland in the brain.
• Ovaries in females and testicles in males are reproductive

organs, or gonads, that maintain the health of their respective
systems. They also function as glands because they produce
and release hormones.
The Human Reproductive Systems Cont’d
The penis is made of several parts:
•The penis is the male sex organ, reaching its full-size during puberty. In addition
to its sexual function, the penis acts as a conduit for urine to leave the body.
•The penis is made of several parts:
•Glans (head) of the penis: In uncircumcised men, the glans is covered with pink,
moist tissue called mucosa. Covering the glans is the foreskin (prepuce). In
circumcised men, the foreskin is surgically removed and the mucosa on the glans
transforms into dry skin.
•
•Corpus cavernosum: Two columns of tissue running along the sides of the penis.
Blood fills this tissue to cause an erection.
The penis is made of several parts Cont’d:
•Corpus spongiosum: A column of sponge-like tissue running along the
front of the penis and ending at the glans penis; it fills with blood during
an erection, keeping the urethra which runs through it open.
•The urethra runs through the corpus spongiosum, conducting urine out
of the body.
•An erection results from changes in blood flow in the penis. When a
man becomes sexually aroused, nerves cause penis blood vessels to
expand. More blood flows in and less flows out of the penis, hardening
the tissue in the corpus cavernosum.
Penis Conditions
 Erectile dysfunction: A man's penis does not achieve sufficient hardness for satisfying
intercourse. Atherosclerosis (damage to the arteries) is the most common cause of erectile
dysfunction.
 Priapism: An abnormal erection that does not go away after several hours even though
stimulation has stopped. Serious problems can result from this painful condition.
 Hypospadias: A birth defect in which the opening for urine is on the front (or underside),
rather than the tip of the penis. Surgery can correct this condition.
 Phimosis (paraphimosis): The foreskin cannot be retracted or if retracted cannot be returned
to its normal position over the penis head. In adult men, this can occur after penis infections.
 Balanitis: Inflammation of the glans penis, usually due to infection. Pain, tenderness, and
redness of the penis head are symptoms.
Penis Conditions Cont’d
 Balanoposthitis: Balanitis that also involves the foreskin (in an uncircumcised man).
 Chordee: An abnormal curvature of the end of the penis, present from birth. Severe cases may
require surgical correction.
 Peyronie’s Disease: An abnormal curvature of the shaft of the penis may be caused by injury
of the adult penis or other medical conditions.
 Urethritis: Inflammation or infection of the urethra, often causing pain with urination and
penis discharge. Gonorrhea and chlamydia are common causes.
 Gonorrhea: The bacteria N. gonorrhea infects the penis during sex, causing urethritis. Most
cases of gonorrhea in men cause symptoms of painful urination or discharge.
 Chlamydia: A bacteria that can infect the penis through sex, causing urethritis. Up to 40% of
chlamydia cases in men cause no symptoms.
Penis Conditions Cont’d
 Syphilis: A bacteria transmitted during sex. The initial symptom of syphilis is
usually a painless ulcer (chancre) on the penis.
 Herpes: The viruses HSV-1 and HSV-2 can cause small blisters and ulcers on
the penis that reoccur over time.
 Micropenis: An abnormally small penis, present from birth. A hormone
imbalance is involved in many cases of micropenis.
 Penis warts: The human papillomavirus (HPV) can cause warts on the penis.
HPV warts are highly contagious and spread during sexual contact.
 Cancer of the penis: Penis cancer is very rare in the us. Circumcision decreases
the risk of penis cancer.
Penis Tests
 Urethral swab: A swab of the inside of the penis is sent for culture. A urethral swab
may diagnose urethritis or other infections.
 Urinalysis: A test of various chemicals present in urine. A urinalysis may detect
infection, bleeding, or kidney problems.
 Nocturnal penis tumescence testing (erection testing): An elastic device worn on the
penis at night can detect erections during sleep. This test can help identify the cause of
erectile dysfunction.
 Urine culture: Culturing the urine in the lab can help diagnose a urinary tract infection
that might affect the penis.
 Polymerase chain reaction (PCR): A urine test that can detect gonorrhea,
chlamydia, or other organisms that affect the penis.
•
Penis Treatments
• Phosphodiesterase inhibitors: These medicines (such as sildenafil or Viagra)
enhance the flow of blood to the penis, making erections harder.
 Antibiotics: Gonorrhea, chlamydia, syphilis, and other bacterial infections of the
penis can be cured with antibiotics.
 Antiviral medicines: Taken daily, medicines to suppress HSV can prevent herpes
outbreaks on the penis.
 Penis surgery: Surgery can correct hypospadias, and may be necessary for penis
cancer.
• Testosterone: Low testosterone by itself rarely causes erectile dysfunction.
Testosterone supplements may improve erectile dysfunction in some men.
Male disorders
•Male disorders include:
 Impotence or erectile dysfunction.
 Low sperm count.
Anatomy of the Female Reproductive System
• The anatomy of the female reproductive system is highly complex in
comparison with that of the male and the female reproductive and
urinary tracts are totally separated.
• The female reproductive organs pro-duce and maintain the egg cells
or oocytes, which are the female sex cells.
• The organs also transport them to the site of fertilization, provide a
strong environment for the developing fetus, give birth to a fetus, and
produce female sex hormones.
• The principal organs of the female reproductive system, besides
the ovaries, are the uterine tubes, uterus, vagina, and the
components of the external genitalia.
Anatomy of the Female Reproductive System Cont’d
• The primary sex organs or gonads are the two ovaries, which reproduce female
sex cells and sex hormones. The accessory sex organs are the internal and
external reproductive organs.
• As in males, a variety of accessory glands releases secretions into the female

reproductive tract.
• The female internal genitalia are primarily located in the pelvic cavity, and
include the ovaries and duct system.
• The accessory ducts include the uterine tubes, uterus, and vagina.
Anatomy of the Female Reproductive System Cont’d
Ovaries
•The female gonads or ovaries are oval-shaped, solid structures about 3.5 cm
long, 2 cm wide, and 1-cm thick.
•They lie in shallow depressions in the lateral pelvic cavity wall on either side of
the uterus.
•The ovaries are suspended by several ligaments in the peritoneal cavity, where
the iliac blood vessels split into a “fork.”
•Each ovary is anchored medially to the uterus by an ovarian ligament and
laterally to the pelvic wall by the suspensory ligament.
Ovaries Cont’d
•Also, a mesovarium suspends each ovary in between these points.

The mesovarium and suspensory ligament are part of a broad ligament, which
folds over the uterus to support the uterus, uterine tubes, and vagina. The ovarian
ligaments are enclosed by the broad ligament.
Ovaries Cont’d
•The ovarian arteries serve the ovaries and are branches of the abdominal aorta. The ovaries
are also served by the ovarian branch of the uterine arteries.
•To reach the ovaries, the ovarian blood vessels must travel through the mesovaria and
suspensory ligaments.
•Each ovary is externally surrounded by a fibrous tunica albuginea. This structure is then
covered by a cuboidal epithelial cell layer that is known as the germinal epithelium. This
epithelium is a continuation of the peritoneum.
•Each ovary additionally has an outer cortex enclosing the developing gametes. An inner
medulla contains the primary blood vessels and nerves. However, the relative area of each
region is not well defined.
Female Duct System
•The female duct system has no or very little contact with the ovaries.
The female reproductive system includes accessory structures,
including two uterine tubes, a uterus, and a vagina.
Uterine Tubes
•The uterine tubes, also called the fallopian tubes or oviducts, receive the ovulated oocytes
from the ovaries and are each about 10 cm (4 inches) long.
•The uterine tubes are the sites where fertilization usually occurs. Each uterine tube empties into
the superolateral area of the uterus via a constricted isthmus.
•As it curves around the ovary, each uterine tube’s distal end expands to form an ampulla.
•Near the ovaries, each tube expands into a funnel shaped infundibulumthat partially encircles
the ovary. Finger-like fimbriae surround its margin with one of the larger extensions connecting
with the ovary.
Female Duct System
•The epithelium lining the uterine tube is composed of ciliated columnar epithelial cells, with
scattered mucin-secreting cells.
•The mucosa is surrounded by concentric smooth muscle layers. The transport of oocytes
involves a combination of ciliary movement and peristaltic contractions in the uterine tube
walls.
•Nonciliated mucosal cells have dense microvilli and produce secretions that keep oocytes as
well as any present sperm nourished and moist.
•The uterine tubes are externally covered by peritoneum, supported by a short mesentery called
the mesosalpinx. This structure is actually part of the broad ligament.
Uterus
•If the secondary oocyte is fertilized to become a zygote, the uterus receives the developing
embryo, sustaining its development. The uterus is hollow and muscular, shaped slightly like an
inverted pear.
•Its size changes during pregnancy, from about 7.5 cm by 5 cm by 2.5 cm to much larger, able
to hold the developing baby up until birth.
•At this point, it weighs 30–40 g. The uterus is located in the anterior pelvic cavity, superior to
the vagina, usually bending over the urinary bladder.
•The uterine body is also called the corpus, the largest portion of the uterus.
Uterus
•The fundus is the rounded portion of the corpus and is superior to the attachment
of the uterine tubes. It ends at the constriction known as the isth-mus.
•The cervix is the interior portion of the uterus, extending from the isthmus to the
vagina.
•The cervix surrounds the cervical orifice, where the uterus opens to the vagina.
The uterine wall is thick, with three layers.
Vagina
•The vagina is a thin-walled fibromuscular tube, about 8–10 cm (3–4 inches) in
length, extending from the cervix to the outside of the body.
•It conveys uterine secretions, receives the erect penis during intercourse, and
provides the open channel for offspring.
•The vagina extends up and back into the pelvic cavity and lies posterior to the
urinary bladder and urethra but anterior to the rectum.
•The urethra is parallel to the course of the vagina anteriorly. The vagina is
attached to these other structures by connective tissues.
Vagina Cont’d
•The hymen is a thin membrane of connective tissue and epithelium that partially covers
the vaginalorifice in females who have not had sexual intercourse.
•It has a central opening that allows uterine and vaginal secretions to pass to the outside of the
body.
•The hymen is extremely vascular and may bleed when it stretches or ruptures during initial
sexual inter-course.
•It can also be ruptured by insertion of tam-pons, sports activities, or pelvic examinations. In
rare cases, it is tougher than normal and requires a surgical procedure for normal intercourse to
occur.
Functions of the Vagina
•The four major functions of the vagina are to serve as a passageway for the
elimination of menstrual fluids,
•to receive the penis during sexual intercourse,
•and to hold the spermatozoa before their passage into the uterus.
•provides the open channel for offspring
•The vagina forms the interior portion of the birth canal, through which the fetus
passes during delivery.
The vaginal wall has three layers:
Inner mucosal layer (mucosa): Stratified squamous epithelium with no mucous
glands. Dendritic cells act as antigen-presenting cells.
They may be the route of HIV transmission from an infected male. This layer has
no glands but is lubricated by the cervical mucous glands.
It also has a mucosal transudate that leaks from the vaginal walls. Large amounts
of glycogen are released by its epithelia, which are metabolized anaerobically by
bacteria to form lactic acid.
Therefore, the pH is very acidic, which helps to fight infections but is harmful to
sperm. Because this fluid is alkaline instead of acidic in adolescent girls, they are
predisposed to STIs if they are sexually active.
The vaginal wall has three layers Cont’d:
•■ Middle muscular layer (muscularis): Mostly smooth muscle fibers; helps to
close the vaginal opening.
•■ Outer fibrous layer (adventitia): Dense connective tissue and elastic fibers.
External Genitalia
•The external accessory organs of the female reproductive system include:
the mons pubis, labia majora, labia minora, clitoris, and vestibular glands.
•They surround the openings of the urethra and vagina, composing
the vulva or pudendum.
•The mons pubis is a rounded area made of fatty tissue that overlies the pubic
symphysis. This area becomes covered with pubic hair after puberty.
External Genitalia
External Genitalia
• The labia majora enclose and protect the other external reproductive organs.
• They are made up of rounded folds of adipose tissue and thin smooth muscle
covered by skin and hair.
• They lie close together, with a cleft that includes the urethral and vaginal
openings separating the labia longitudinally.
• The labia majora are analogous to the male scrotum and enclose the labia minora.
External Genitalia Cont’d
• The labia minora are flattened, hairless longitudinal folds composed of
connective tissue.
• They contain the external openings of the urethra and vagina. They have a rich
blood supply, and therefore a pinkish appearance.
• They merge posteriorly with the labia majora to form a ridge called
the fourchette.
• Anteriorly, they converge to form the hood-like covering of the clitoris.

External Genitalia Cont’d
• The clitoris projects from the anterior end of the vulva between the labia minora. It is usually
about 2 cm in length and 0.5 cm in diameter. It corresponds to the penis in males, with a similar
structure.
• It is made up of two columns of erectile tissue called the corpora cavernosa and forms a glans
at its anterior end that has many sensory nerve fibers.
• The exposed portion is called the glans of the clitoris and the hooded fold is called the prepuce
of the clitoris.
• The clitoris has a rich innervation of sensory nerve endings and swells with blood, becoming
erect during tactile stimulation and sexual arousal.
Female disorders include:
 Early or delayed puberty.
 Endometriosis, a condition where the tissue that normally lines inside the womb,
known as the endometrium, grows outside of it.
 Inadequate breastmilk supply.
 Infertility or reduced fertility (difficulty getting pregnant).
 Menstrual problems including heavy or irregular bleeding.
 Polycystic ovary syndrome, ovaries produce more male hormones than normal.
 Problems during pregnancy.
 Uterine fibroids, noncancerous growths in a woman’s uterus or womb.
•Scientists believe environmental factors likely play a role in some reproductive disorders.
Research shows exposure to environmental factors could affect reproductive health in the
following ways:
 Exposure to lead is linked to reduced fertility in both men and women.
 Mercury exposure has been linked to issues of the nervous system like memory, attention, and
fine motor skills.
 Exposure to diethylstilbestrol (DES), a drug once prescribed to women during pregnancy, can
lead to increased risks in their daughters of cancer, infertility, and pregnancy complications.
 Exposure to endocrine-disrupting compounds, chemicals that interfere with the body’s
hormones, may contribute to problems with puberty, fertility, and pregnancy.
• Heavy lifting or shift work and decreased fertility – Two occupational factors for
women – lifting heavy loads or working non-daytime schedules – are associated
with fewer eggs in their ovaries, which could indicate decreased fertility.
Key concepts of Genes and Chromosomes
• Chromosomes are threadlike structures made of protein and a single molecule
of DNA that serve to carry the genomic information from cell to cell
• DNA stands for deoxyribonucleic (dee-OK-see-ri-bo-new-klee-ik) acid. It is the
genetic information inside the cells of the body that helps make people who
they are
• the smallest unit that can live on its own and that makes up all living organisms
and the tissues of the body.
• A gene is the basic physical and functional unit of heredity. Genes are made up
of DNA
• A mutation is a change in the DNA sequence of an organism. Mutations can
result from errors in DNA replication during cell division, exposure to mutagens
or a viral infection.
Key concepts of Genes and Chromosomes
• Marfan syndrome is a genetic disorder that changes the proteins that help
make healthy connective tissue. This leads to problems with the development of
connective tissue, which supports the bones, muscles, organs, and tissues in your
body.
• Huntington's disease (HD) is an inherited disorder that causes nerve cells

(neurons) in parts of the brain to gradually break down and die.
CHROMOSOMES
•Chromosomes are the structures in cells that hold genes. Each person
has 23 pairs of chromosomes, or 46 in all.
•For each pair, you get one chromosome from your mother and one from
your father. Just like genes, sometimes chromosomes change.
•There may be too many or too few chromosomes, or part of a

chromosome may be missing.
•These changes can cause chromosomal conditions in a baby.

CHROMOSOMES Cont’d
• One of the most common chromosomal conditions is Down
syndrome (when there are three copies of chromosome 21).
• Parents can pass chromosome changes to their children, or they can

happen on their own as cells develop.
•Any condition related to genes or chromosomes can be called a genetic

condition.
CHROMOSOMES
•A chromosome is made of a very long strand of DNA and contains

many genes (hundreds to thousands).
•The genes on each chromosome are arranged in a particular sequence,
and each gene has a particular location on the chromosome (called its
locus).
•In addition to DNA, chromosomes contain other chemical components

that influence gene function.
GENES
•Genes are part of the cells in your body. They store instructions for the
way your body grows, looks and works.
•Your genes make you the way you are — they help control things like
your height, the curliness of your hair and the color of your eyes. You
inherit (get) genes from your parents.
• Sometimes the instructions in genes change. This is called a gene

change or a mutation. You can pass gene changes to your children.
GENE-ISSUES
•You can pass gene changes to your children. Sometimes a gene change
can cause health conditions, like cystic fibrosis and sickle cell disease. A
gene change also can cause birth defects, like heart defects.
•These are called single gene disorders, and they run in families. A birth
defect is a health condition that is present in a baby at birth.
•Birth defects change the shape or function of one or more parts of the
body. They can cause problems in overall health, in how the body
develops or in how the body works.
GENE-ISSUES Cont’d
•Humans have about 20,000 to 23,000 genes.
•Genes are segments of deoxyribonucleic acid (DNA) that contain the code for a
specific protein that functions in one or more types of cells in the body.
Chromosomes are structures within cells that contain a person's genes.
 Genes are contained in chromosomes, which are in the cell nucleus.
 A chromosome contains hundreds to thousands of genes.
 Every normal human cell contains 23 pairs of chromosomes, for a total of
46 chromosomes.
 A trait is any gene-determined characteristic and is often determined by more
than one gene.
 Some traits are caused by mutated genes that are inherited or that are the result of
a new gene mutation.
•Proteins are probably the most important class of material in the body. Proteins
are not just building blocks for muscles, connective tissues, skin, and other
structures. They also are needed to make enzymes.
•Enzymes are complex proteins that control and carry out nearly all chemical
processes and reactions within the body. The body produces thousands of different
enzymes.
•Thus, the entire structure and function of the body is governed by the types and
amounts of proteins the body synthesizes.
•Protein synthesis is controlled by genes, which are contained on chromosomes.

•The genotype (or genome) is a person’s unique combination of genes or genetic
makeup. Thus, the genotype is a complete set of instructions on how that person’s
body synthesizes proteins and thus how that body is supposed to be built and
function.
•The phenotype is the actual structure and function of a person’s body.
•The phenotype is how the genotype manifests in a person—not all the instructions
in the genotype may be carried out (or expressed).
•Whether and how a gene is expressed is determined not only by the genotype but
also by the environment (including illnesses and diet) and other factors, some of
which are unknown.
A karyotype is a picture of the full set of chromosomes in a person’s cells.
Structure of DNA
•DNA (deoxyribonucleic acid) is the cell’s genetic material, contained in
chromosomes within the cell nucleus and mitochondria.
•Except for certain cells (for example, sperm and egg cells and red blood cells), the
cell nucleus normally contains 23 pairs of chromosomes. A chromosome contains
many genes.
•A gene is a segment of DNA that provides the code to construct a protein.
• The DNA molecule is a long, coiled double helix that resembles a spiral
staircase. In it, two strands, composed of sugar (deoxyribose) and phosphate
molecules, are connected by pairs of four molecules called bases, which form the
steps of the staircase.
Structure of DNA Cont’d
•The DNA molecule is a long, coiled double helix that resembles a spiral staircase.
•In it, two strands, composed of sugar (deoxyribose) and phosphate molecules, are
connected by pairs of four molecules called bases, which form the steps of the
staircase.
•In the steps, adenine is paired with thymine and guanine is paired with cytosine.
Each pair of bases is held together by a hydrogen bond.
•A gene consists of a sequence of bases. Sequences of three bases code for an

amino acid (amino acids are the building blocks of proteins) or other information.
Structure of DNA Cont’d
Synthesizing proteins
• Proteins are composed of a long chain of amino acids linked together one after
another. There are 20 different amino acids that can be used in protein synthesis
—some must come from the diet (essential amino acids), and some are made by
enzymes in the body.
• As a chain of amino acids is put together, it folds upon itself to create a complex
three-dimensional structure. It is the shape of the folded structure that determines
its function in the body.
• Because the folding is determined by the precise sequence of amino acids, each
different sequence results in a different protein.
• Some proteins (such as hemoglobin) contain several different folded chains.

Instructions for synthesizing proteins are coded within the DNA.
Replication
•Cells reproduce by dividing in two. Because each new cell requires a complete set
of DNA molecules, the DNA molecules in the original cell must reproduce
(replicate) themselves during cell division.
•Replication happens in a manner similar to transcription, except that the entire

double-strand DNA molecule unwinds and splits in two.
•After splitting, bases on each strand bind to complementary bases (A with T, and G
with C) floating nearby. When this process is complete, two identical double-strand
DNA molecules exist.
Mutations
• Mutations may be unique to an individual or family, and most harmful mutations
are rare. Mutations that become so common that they affect more than 1% of a
population are called polymorphisms (for example, the human blood types A, B,
AB, and O).
• Most polymorphisms have little or no effect on the phenotype

(the actual structure and function of a person’s body).
•The slow changes that occur over time caused by mutations and natural selection
in an interbreeding population collectively are called evolution.
•Did You Know... Not all gene abnormalities are harmful. For example, the gene
that causes sickle cell disease also provides protection against malaria.
Genetic Disorders
• A genetic disorder is a detrimental trait caused by an abnormal gene. The abnormal
gene may be inherited or may arise spontaneously as a result of a new mutation. Gene
abnormalities are fairly common.
• Humans carry an average of 100 to 400 abnormal genes. However, most of the time the
corresponding gene on the other chromosome in the pair is normal and prevents any
harmful effects.
• In the general population, the chance of a person having two copies of the same
abnormal gene (and hence a disorder) is very small.
• However, in children who are offspring of close blood relatives, the chances are higher.
Genetic and Chromosomal Conditions
 Genes and chromosomes sometimes change or have missing or extra parts. This
can cause serious health conditions and birth defects in your baby.
 You can have tests before and during pregnancy to find out of your baby is at
risk for or has certain genetic conditions and birth defects.
 A genetic counselor can help you understand test results and how genetics, birth
defects and other medical conditions run in families.
• Your family health history can help you; your provider and your genetic
counselor identify genetic conditions that run in your family.
Genetic counseling
 Genetic counseling helps you understand how genes, birth defects and other
medical conditions run in families, and how they can affect your health and your
baby's health.
 You get genetic counseling from a genetic counselor. This person is trained to
know about genetics, birth defects and other medical problems that run-in
families.
 She can help you understand the causes of genetic conditions, what kind of
testing is available, and your chances of having a baby with a genetic condition.
 To find a genetic counselor in your area, talk to your health care provider or
contact the National Society of Genetic Counselors.
Genetic counseling Cont’d
•How can you find out if your baby is at risk for a genetic condition?
•Your baby may be at increased risk of having a genetic condition if:
 You or your partner has a genetic condition.
 You have a child with a genetic condition.
• A genetic condition runs in you or your partner’s family or ethnic group. An

ethnic group is a group of people, often from the same country, who share
language or culture.
• Before pregnancy, you can have carrier screening tests that check your blood or
saliva to see if you’re a carrier of certain genetic conditions.
Pairing
•Except for certain cells (for example, sperm and egg cells or red blood cells), the
nucleus of every normal human cell contains 23 pairs of chromosomes, for a total
of 46 chromosomes.
•Normally, each pair consists of one chromosome from the mother and one from
the father.
•There are 22 pairs of non-sex (autosomal) chromosomes and one pair of sex
chromosomes.
Pairing Cont’d
•Paired non-sex chromosomes are, for practical purposes, identical in size, shape,
and position and number of genes.
•Because each member of a pair of non-sex chromosomes contains one of each

corresponding gene, there is in a sense a backup for the genes on those
chromosomes.
•The 23rd pair is the sex chromosomes (X and Y).

Sex chromosomes
•The pair of sex chromosomes determines whether a fetus becomes male
or female. Males have one X and one Y chromosome.
•A male’s X comes from his mother and the Y comes from his father.
•Females have two X chromosomes, one from the mother and one from
the father.
•In certain ways, sex chromosomes function differently than non-sex

chromosomes.
Sex chromosomes Cont’d
•The smaller Y chromosome carries the genes that determine male sex as well as a
few other genes.
•The X chromosome contains many more genes than the Y chromosome, many of
which have functions besides determining sex and have no counterpart on the Y
chromosome.
•In males, because there is no second X chromosome, these extra genes on the X
chromosome are not paired and virtually all of them are expressed.
•Genes on the X chromosome are referred to as sex-linked, or X-linked genes.

•Normally, in the nonsex chromosomes, the genes on both of the pairs of
chromosomes are capable of being fully expressed.
•However, in females, most of the genes on one of the two X chromosomes are
turned off through a process called X inactivation (except in the eggs in the
ovaries).
•X inactivation occurs early in the life of the fetus.
•In some cells, the X from the father becomes inactive, and in other cells, the X
from the mother becomes inactive.
•Thus, one cell may have a gene from the person’s mother and another cell has the
gene from the person’s father.
•Because of X inactivation, the absence of one X chromosome usually results in

relatively minor abnormalities (such as Turner syndrome).
•Thus, missing an X chromosome is far less harmful than missing a nonsex

chromosome.
Inactive X Chromosome
•If a female has a disorder in which she has more than two X chromosomes, the
extra chromosomes tend to be inactive.
•Thus, having one or more extra X chromosomes causes far fewer developmental
abnormalities than having one or more extra non-sex chromosomes.
•For example, women with three X chromosomes (triple X syndrome) are often
physically and mentally normal.
•Males who have more than one Y chromosome (see XYY Syndrome) may have
physical and mental abnormalities.
Chromosome abnormalities
• There are several types of chromosome abnormalities. A person may have an
abnormal number of chromosomes or have abnormal areas on one or more
chromosomes.
•Many such abnormalities can be diagnosed before birth (see Testing for
chromosome and gene abnormalities).
• Abnormal numbers of nonsex chromosomes usually result in severe
abnormalities.
• For example, receiving an extra non-sex chromosome may be fatal to a fetus or

lead to abnormalities such as Down syndrome, which commonly results from a
person having three copies of chromosome 21.
Chromosome abnormalities Cont’d
•Absence of a nonsex chromosome is fatal to the fetus.
•Large areas on a chromosome may be abnormal, usually because a whole section

was left out (called a deletion) or mistakenly placed in another chromosome (called
translocation).
•For example, chronic myelogenous leukemia is sometimes caused by translocation

of part of chromosome 9 onto chromosome 22.
•This abnormality can be inherited or be the result of a new mutation.

Mitochondrial chromosomes
•Mitochondria are tiny structures inside cells that synthesize molecules used for
energy. Unlike other structures inside cells, each mitochondrion contains its own
circular chromosome.
•This chromosome contains DNA (mitochondrial DNA) that codes for some, but
not all, of the proteins that make up that mitochondrion.
•Mitochondrial DNA usually comes only from the person’s mother because, in
general, when an egg is fertilized, only mitochondria from the egg become part of
the developing embryo.
•Mitochondria from the sperm usually do not become part of the developing
embryo.
Traits
•A trait is any gene-determined characteristic. Many traits are determined by the
function of more than one gene.
•For example, a person's height is likely to be determined by many genes, including

those affecting growth, appetite, muscle mass, and activity level.
•However, some traits are determined by the function of a single gene.

Traits Cont’d
•Variation in some traits, such as eye color or blood type, is considered normal.
•Other variations, such as albinism, Marfan syndrome, and Huntington disease,

harm body structure or function and are considered disorders.
•However, not all such gene abnormalities are uniformly harmful.
•For example, one copy of the sickle cell gene can provide protection against
malaria, but two copies of the gene cause sickle cell anemia.
Genetic Diversity
•Genetic diversity is the total number of genetic characteristics in the genetic
makeup of a species, it ranges widely from the number of species to differences
within species and can be attributed to the span of survival for a species.
•It is distinguished from genetic variability, which describes the tendency of

genetic characteristics to vary.
Genetic Diversity
•Genetic diversity serves as a way for populations to adapt to changing
environments.
•With more variation, it is more likely that some individuals in a population will
possess variations of alleles that are suited for the environment.
•Those individuals are more likely to survive to produce offspring bearing that
allele.
•The population will continue for more generations because of the success of these
individuals.
Evolutionary importance of genetic diversity
•Adaptation
• Variation in the population’s gene pool allows natural selection to act upon traits
that allow the population to adapt to changing environments.
• Selection for or against a trait can occur with changing environment – resulting in
an increase in genetic diversity (if a new mutation is selected for and maintained)
or a decrease in genetic diversity (if a disadvantageous allele is selected against).
• The more genetic diversity a population has, the more likelihood the population
will be able to adapt and survive.
Cont’d
•Small populations
• Large populations are more likely to maintain genetic material and thus generally
have higher genetic diversity.
• Small populations are more likely to experience the loss of diversity over time by
random chance, which is called genetic drift.
• When an allele (variant of a gene) drifts to fixation, the other allele at the same
locus is lost, resulting in a loss in genetic diversity.
• In small population sizes, inbreeding, or mating between individuals with similar

genetic makeup, is more likely to occur, thus perpetuating more common alleles
to the point of fixation, thus decreasing genetic diversity.
Cont’d
•Mutation
•Random mutations consistently generate genetic variation. A mutation will increase
genetic diversity in the short term, as a new gene is introduced to the gene pool.
•However, the persistence of this gene is dependent of drift and selection (see above).
Most new mutations either have a neutral or negative effect on fitness, while some have a
positive effect.
•A beneficial mutation is more likely to persist and thus have a long-term positive effect
on genetic diversity.
•Mutation rates differ across the genome, and larger populations have greater mutation
rates.
•In smaller populations a mutation is less likely to persist because it is more likely to be
eliminated by drift.
Cont’d
•Gene flow
•Gene flow, often by migration, is the movement of genetic material (for example
by pollen in the wind, or the migration of a bird).
•Gene flow can introduce novel alleles to a population. These alleles can be
integrated into the population, thus increasing genetic diversity.
Cont’d
•Human intervention
•Attempts to increase the viability of a species by increasing genetic diversity is called
genetic rescue.
•For example, eight panthers from Texas were introduced to the Florida panther
population, which was declining and suffering from inbreeding depression.
•Genetic variation was thus increased and resulted in a significant increase in population
growth of the Florida Panther.
•Creating or maintaining high genetic diversity is an important consideration in species

rescue efforts, in order to ensure the longevity of a population.
PREGNANCY AND BIRTH
•From conception to birth, a woman’s body goes through a number of astonishing
changes as it prepares to carry and grow a new life.
•A new organ, the placenta, is formed to supply the unborn child with everything
he or she needs.
•The woman’s body retains more water, and a larger volume of blood circulates
than before.
•Both of these changes become noticeable early on in the form of increased body
weight.
PREGNANCY AND BIRTH Cont’d
•The mammary glands in the breasts prepare to produce milk. Connective tissue,
ligaments, tendons and muscles become more flexible to allow for natural birth.
•All of these changes are triggered and maintained by hormones.
•During pregnancy, the body produces more hormones than it ever will at any other
time.
•Pregnancy begins with the fertilization of an egg and continues through to the
birth of the individual.
PREGNANCY AND BIRTH Cont’d
•The length of time of gestation varies among animals, but is very similar among
the great apes: human gestation is 266 days, while chimpanzee gestation is 237
days, a gorilla’s is 257 days, and orangutan gestation is 260 days long.
•The fox has a 57-day gestation. Dogs and cats have similar gestations averaging
60 days.
•The longest gestation for a land mammal is an African elephant at 640 days.
•The longest gestations among marine mammals are the beluga and sperm whales
at 460 days.
Human Gestation
•Twenty-four hours before fertilization, the egg has finished meiosis and becomes a
mature oocyte. When fertilized (at conception) the egg becomes known as a zygote.
•The zygote travels through the oviduct to the uterus.
•The developing embryo must implant into the wall of the uterus within seven
days, or it will deteriorate and die.
•The outer layers of the zygote (blastocyst) grow into the endometrium by
digesting the endometrial cells, and wound healing of the endometrium closes up
the blastocyst into the tissue.
Human Gestation
•Another layer of the blastocyst, the chorion, begins releasing a hormone called
human beta chorionic gonadotropin (β-HCG) which makes its way to the corpus
luteum and keeps that structure active.
•This ensures adequate levels of progesterone that will maintain the endometrium
of the uterus for the support of the developing embryo.
•Pregnancy tests determine the level of β-HCG in urine or serum.
•If the hormone is present, the test is positive.
•In humans, fertilization occurs soon after the oocyte leaves the ovary. Implantation
occurs eight or nine days later.
The course of pregnancy
•In early pregnancy, the physical changes are hardly noticeable. Skin may appear
rosy because of increased circulation of blood.
•But most pregnant women notice that their body is changing: Many of them feel
tired faster, their appetite changes, their breasts feel tender, and they may feel
nauseous, especially in the morning (“morning sickness”).
•Hormonal changes often influence a woman’s emotions, particularly in the first

three months of pregnancy.
•Women might react more sensitively than they otherwise would, and might change
their opinions about some things. And it's not always easy to adjust to the new
challenges that lie ahead – especially if the pregnancy wasn't planned.
The course of pregnancy Cont’d
•The gestation period is divided into three equal periods or trimesters. During the
first two to four weeks of the first trimester, nutrition and waste are handled by the
endometrial lining through diffusion.
•As the trimester progresses, the outer layer of the embryo begins to merge with the
endometrium, and the placenta forms.
•This organ takes over the nutrient and waste requirements of the embryo and fetus,
with the mother’s blood passing nutrients to the placenta and removing waste from
it.
•Chemicals from the fetus, such as bilirubin, are processed by the mother’s liver for
elimination.
•Some of the mother’s immunoglobulins will pass through the placenta, providing
passive immunity against some potential infections.
•Internal organs and body structures begin to develop during the first trimester.
•By five weeks, limb buds, eyes, the heart, and liver have been basically formed.
•By eight weeks, the term fetus applies, and the body is essentially formed
•The individual is about five centimeters (two inches) in length and many of the
organs, such as the lungs and liver, are not yet functioning.
•Exposure to any toxins is especially dangerous during the first trimester, as all of
the body’s organs and structures are going through initial development.
•Anything that affects that development can have a severe effect on the fetus’
survival.
•The second trimester of pregnancy is often the most pleasant for women.
•Their body has now completely adjusted to the pregnancy, but the size of their
belly and their body weight are still not too much of a problem in everyday life.
•Most women start feeling emotionally balanced again, and some develop a special
energy and feel good in their body.
•At this point the child’s movements are usually quite noticeable.
•During the second trimester, the fetus grows to about 30 cm (12 inches), as shown
in the figure below.
•It becomes active and the mother usually feels the first movements. All organs and
structures continue to develop.
•The placenta has taken over the functions of nutrition and waste and the
production of estrogen and progesterone from the corpus luteum, which has
degenerated.
•The placenta will continue functioning up through the delivery of the baby.
•During the Third or final trimester, the child matures quickly, and gets bigger and
heavier.
•Towards the end of the pregnancy, most women have problems associated with
their growing belly, and everyday tasks gradually become more difficult.
•In the ninth month, the focus of pregnancy shifts to the upcoming birth – women
may start feeling more excited about, but also more daunted by, what is about to
happen.
•During the third trimester, the fetus grows to 3 to 4 kg (6 ½ -8 ½ lbs.) and about
50 cm (19-20 inches) long, as illustrated in the figure below. This is the period of
the most rapid growth during the pregnancy.
•Organ development continues to birth (and some systems, such as the nervous
system and liver, continue to develop after birth).
•The mother will be at her most uncomfortable during this trimester. She may
urinate frequently due to pressure on the bladder from the fetus.
•There may also be intestinal blockage and circulatory problems, especially in her
legs.
•Clots may form in her legs due to pressure from the fetus on returning veins as
they enter the abdominal cavity.
Everyday life
• Everyday life also changes over the course of a pregnancy: Preparing for the
arrival of the new baby takes up quite a bit of time.
• Most pregnant women gradually start to need more and more time to do
everyday tasks, and working women go on maternity leave towards the end of
the pregnancy.
• It is common for women to pay more attention to their health than they used to.
• This includes thinking about questions related to nutrition and exercise: What
should I eat, and do I need to take dietary supplements? How much weight gain
is still considered normal? Can I continue to do sports and, if so, what do I need
to consider?
Everyday life Cont’d
• Because alcohol and nicotine can cause serious harm to the unborn child, the
vast majority of women don't drink alcohol or smoke during pregnancy.
• Many women use a planned pregnancy as an occasion to give up smoking.

Smoking during pregnancy increases the risk of things like miscarriage, preterm
birth and low birth weight.
• But it's not always easy for women who smoke to quit, and a lot of them will
need help doing so.
• It's not clear whether nicotine replacement therapy is suitable for pregnant
women. Other programs for quitting are probably just as effective.
Pregnancy-related problems
• Some women feel fully healthy in pregnancy, and some feel even healthier than
ever before.
• But many have typical problems associated with pregnancy. These tend to
change over the months: Nausea is a common problem at the start.
• Later on, as more weight is gained, problems may include back pain, heartburn,
water retention, varicose veins, having to go to the toilet a lot, or sleep
problems.
Pregnancy-related problems Cont’d
• Because these problems are often seen as being associated with a larger positive
change, and they usually go away without treatment, most pregnant women
cope well with them.
• And a number of things can be done to relieve pregnancy-related problems.

Pregnancy-related problems Cont’d
• Illnesses
• Some medical conditions, such as pre-eclampsia, only develop during pregnancy.
• Women who have gestational diabetes are more likely to develop pre-eclampsia.
Some pregnant women who have a chronic condition like asthma or diabetes
wonder whether they can continue to take their medication.
• The answer is yes, and it is usually even necessary to do so.
• For example, not getting enough oxygen during an asthma attack would be more
dangerous for the baby than possible drug side effects.
Prenatal examinations
• Nowadays, pregnant women receive a lot of medical care. Routine preventive
examinations are used to check whether the child is developing normally and if
the woman is healthy.
• In Germany, women who don't have any special risk factors are offered three
ultrasound exams during pregnancy. More ultrasounds may be needed later on
to look into any irregularities.
• In addition to the ultrasound scans and blood tests, urine tests are also done. A
test for gestational diabetes is offered, too.
• In Germany, special maternity guidelines (Mutterschafts-Richtlinie) determine

what examinations and tests are to be done, and how.
Birth
• Towards the end of pregnancy, most women want labor to finally start, but also
have mixed feelings about the birth.
• Even though many women carefully prepare for it, nobody knows what it will
actually be like. It's normal to feel at least a little daunted.
• The course a birth takes can only be planned to a certain degree – for example,
how long it will take, how painful it will be, and whether there will be any
complications. These things are only clear once the baby is there.
Birth Cont’d
• Nowadays there are a number of ways to relieve labor pain. If the pain becomes
too bad, medication can help. Local anesthetics are the most effective
medications.
• Some are also suitable if a Cesarean section needs to be performed. These

substances don't harm the child.
• If the due date has already passed, waiting for childbirth can become a real test
of patience.
• Being one to two weeks late is usually no cause for concern, but after that the
risk of health problems in the child increases somewhat. The birth is usually
induced two weeks after the due date at the latest.
Birth Cont’d
• Children who are born long before their due date often need special care.
• If there is reason to believe that a baby will be born too early (preterm), the
chances of a healthy start to their life can be improved, for example by using
medication to help their lungs mature faster.
Labour and Birth
• Labour is the physical efforts of expulsion of the fetus and the placenta from the
uterus during birth (parturition).
• Toward the end of the third trimester, estrogen causes receptors on the uterine
wall to develop and bind the hormone oxytocin.
• At this time, the baby reorients, facing forward and down with the back or
crown of the head engaging the cervix (uterine opening).
Giving birth - early signs of labour
• Early signs of labour
• Giving birth will be different for every woman, but the main signs that you are
starting labour will most likely be strong, regular contractions, and a 'show'.
During your pregnancy, a plug of mucus sits in your cervix. A show is when that
plug of mucus comes away, indicating that the cervix is starting to open.
• Other signs that you are going into labour can include:
•• your waters breaking (rupture of the membranes)
•• backache, or an upset stomach
•• cramping or tightening, similar to period pain
•• a feeling of pressure, as the baby's head moves into the pelvis
• an urge to go to the toilet caused by your baby's head pressing in your bowel
Stages of labour
• There are three stages to labour.
• The first stage is when the contractions increase, and the cervix begins to open
up (dilate).
• During stage one, the cervix thins and dilates. This is necessary for the baby and
placenta to be expelled during birth.
• The cervix will eventually dilate to about 10 cm. This is usually the longest stage.
Stages of labour Cont’d
• The second stage of labour is when the cervix is fully open. This is the part of
labour where the mother helps the baby move through her vagina by pushing
with the contractions. During stage two, the baby is expelled from the uterus.
The uterus contracts and the mother pushes as she compresses her abdominal
muscles to aid the delivery.
• The third stage is after the birth of the baby, when the womb contracts and
causes the placenta to come out through the vagina. This last stage is when the
passage of the placenta after the baby has been born and the organ has
completely disengaged from the uterine wall. If labour should stop before stage
two is reached, synthetic oxytocin, known as Pitocin, can be administered to
restart and maintain labour.
Stages of labour Cont’d
• An alternative to labour and delivery is the surgical delivery of the baby through
a procedure called a Caesarian Section. This is major abdominal surgery and can
lead to post-surgical complications for the mother, but in some cases, it may be
the only way to safely deliver the baby.
• The mother’s mammary glands go through changes during the third trimester to
prepare for lactation and breastfeeding. When the baby begins suckling at the
breast, signals are sent to the hypothalamus causing the release of prolactin
from the anterior pituitary. Prolactin causes the mammary glands to produce
milk.
After the birth
• Right after childbirth, tests are done to check on the baby’s general wellbeing
and see whether everything is alright. This group of tests is called "U1" in
Germany, and it includes checking the baby's heart sounds and pulse. Most
babies are born healthy, though.
• Within the first two days of the birth, babies who have statutory health
insurance can have a "pulse oximetry" screening test free of charge. This test is
used to detect serious, but rare, heart problems that can then be treated earlier.
After the birth
• After birth, the mother’s body recovers gradually. It takes a while for everything
to heal and for the womb to return to normal. If all goes well, the first few
weeks with the new baby can be a special, peaceful and happy time. Many
fathers also plan a break from their work to get to know the newborn baby and
help support their partner.
• For some time after childbirth, a lot of women weigh more than they did before
becoming pregnant.
• It usually takes about half a year to get back to their original weight. But even if
that doesn't happen, the extra weight is usually only a health problem in women
who became very overweight during pregnancy. Right after giving birth isn't a
good time to try to lose weight. Combining changes in diet with a lot of exercise
can help in the long term.
Puerperal changes
• Puerperal changes begin almost immediately after delivery, triggered by a sharp
drop in the levels of estrogen and progesterone produced by the placenta during
pregnancy.
• The uterus shrinks back to its normal size and resumes its prebirth position by
the sixth week.
• During this process, called involution, the excess muscle mass of the pregnant
uterus is reduced, and the lining of the uterus (endometrium) is reestablished,
usually by the third week.
Puerperal changes Cont’d
• While the uterus returns to its normal condition, the breasts begin lactation.
Colostrum, a high-protein form of milk, is produced by the second day after the
birth and is gradually converted to normal breast milk, which has less protein
and more fat, by the middle of the second week.
• The chief medical problems associated with the puerperium include usually
mild, transient depression, resulting from emotional letdown and discomfort
associated with puerperal changes; clotting disorders, caused by blood stasis
and prevented by an early return to normal activity; bleeding from a retained
placenta; and puerperal fever, a major cause of maternal death until the 19th
century. A combination of improved sanitary measures and modern antibiotics
has now greatly reduced the mortality associated with puerperal fever.
Contraception and Birth Control
• The prevention of a pregnancy comes under the term contraception or birth
control.
• Strictly speaking, contraception refers to preventing the sperm and egg from
joining. Both terms are, however, frequently used interchangeably.
Contraception and Birth Control
Contraceptive Methods
Method Examples Failure Rate in Typical Use Over 12 Months
male condom, female condom, sponge, cervical cap,

Barrier 15 to 24%
diaphragm, spermicides
Hormonal oral, patch, vaginal ring 8%
Injection 3%
Implant less than 1%
Other natural family planning 12 to 25%
Withdrawal 27%
Sterilization less than 1%

Infertility
• Infertility is the inability to conceive a child or carry a child to birth. About 75
percent of causes of infertility can be identified; these include diseases, such as
sexually transmitted diseases that can cause scarring of the reproductive tubes
in either men or women, or developmental problems frequently related to
abnormal hormone levels in one of the individuals.
• Inadequate nutrition, especially starvation, can delay menstruation. Stress can

also lead to infertility.
• Short-term stress can affect hormone levels, while long-term stress can delay
puberty and cause less frequent menstrual cycles. Other factors that affect
fertility include toxins (such as cadmium), tobacco smoking, marijuana use,
gonadal injuries, and aging.
Infertility Cont’d
• If infertility is identified, several assisted reproductive technologies (ART) are
available to aid conception.
• A common type of ART is in vitro fertilization (IVF) where an egg and sperm are
combined outside the body and then placed in the uterus.
• Eggs are obtained from the woman after extensive hormonal treatments that
prepare mature eggs for fertilization and prepare the uterus for implantation of
the fertilized egg.
• Sperm are obtained from the man and they are combined with the eggs and
supported through several cell divisions to ensure viability of the zygotes.
Infertility Cont’d
• When the embryos have reached the eight-cell stage, one or more is implanted
into the woman’s uterus.
• If fertilization is not accomplished by simple IVF, a procedure that injects the
sperm into an egg can be used.
• This is called intracytoplasmic sperm injection (ICSI) and is shown in the figure
below.
• IVF procedures produce a surplus of fertilized eggs and embryos that can be
frozen and stored for future use. The procedures can also result in multiple
births.
FAMILY
• Family could be viewed as a social establishment within the wider society. Its
description is culture bound and for that matter is dependent on the particular
society of reference.
• As a global phenomenon however, it may be defined as the fundamental
unit of a social life comprising a group of people related to each other
through marriages, blood/birth or adoption.
• It is noteworthy, though that besides being a concept, it also possesses a

structure because it consists of permanent relationships.
• Generally speaking, the family is said to be the basic unit of society. Its members
may live together at one location or not.
Types of Family Systems
•There are two main categorisations of family systems.
•These are the nuclear and the extended.
•However, different types of the nuclear form such as ‘single parent’ and the
‘blended’ family exist.
Functions of the Family
i. The family performs the functions of procreation. The family reproduces to
replace dead members of the society. This ensures continuity of the society.
ii. The family also provides for the physical needs of its members such as shelter,
food and clothing and other material needs.
iii.Another function is to transmit the society’s culture to the child. In the home
the child learns how to interact and work with others and fit into the community
he or she find himself.
iv.Another function is to give status and identity to its members. When a child is
born the family sees to it that every child is given a name. This gives the child
his/her identity. People are able to tell the family and clan to which an
individual is born.
Functions of the Family Cont’d
i. The family gives basic religions and moral training to its members. Baptism, ordination,
comfort in sickness, etc. are all focal points of which the family provides religious and moral
support.
ii. Another function of the family is to provide the health needs of its members, members are
obliged to protect each other from diseases and care for the unfortunate ones in times of
sickness. No wonder members spend huge sums to care for their relatives who are
hospitalized.
iii.It is also the role of family members to provide education to relatives as a long-term
investment, progress and development of the entire family. It is in line with this that, children
are sent to stay with their relatives to go to school and learn a trade.
iv. It also serves as an economic unit by opening and operating business units for the entire
family.
The Role of Family in Child Development
•Humans rely heavily on learning for child development.
•Because we are not born knowing how to behave in society, we have to learn
many of the behaviors from the environment around us growing up. For most of
us, this learning starts with the family at home.
•Learning comes in many forms. Sometimes children learn by being told

something directly.
•However, the most common way children learn is by observation of everyday

life.
•A child’s learning and socialization are most influenced by their family since the
family is the child’s primary social group.
The Role of Family in Child Development Cont’d
•Child development happens physically, emotionally, socially, and intellectually
during this time.
•To make an analogy, if you were constructing a large building, you have to make
sure that it has a solid foundation so that the rest of the building can stand tall and
strong for many years to come.
•If the foundation is not strong, the building will have trouble standing on its own.
Just like people, if our foundations are not solid, we find it more difficult to be
successful in our relationships with others, work, health, and ourselves. So, it
cannot be stressed enough how important the family is in development of a child.
•Ultimately, the family will be responsible for shaping a child and developing
their values, skills, socialization, and security.
The Family Life Cycle
•Stages of Family Life
•As we have established, the concept of family has changed greatly in recent
decades. Historically, it was often thought that most (certainly many) families
evolved through a series of predictable stages.
•Developmental or “stage” theories used to play a prominent role in family

sociology (Strong and DeVault 1992).
•Today, however, these models have been criticized for their linear and
conventional assumptions as well as for their failure to capture the diversity of
family forms.
•While reviewing some of these once-popular theories, it is important to identify

their strengths and weaknesses.
The Family Life Cycle Cont’d
• The set of predictable steps and patterns families experience over time is
referred to as the family life cycle.
• One of the first designs of the family life cycle was developed by Paul Glick in
1955.
• In Glick’s original design, he asserted that most people will grow up, establish
families, rear and launch their children, experience an “empty nest” period, and
come to the end of their lives.
• This cycle will then continue with each subsequent generation (Glick 1989).
Glick’s colleague, Evelyn Duvall, elaborated on the family life cycle by
developing these classic stages of family (Strong and DeVault 1992):
Stage Theory
Stage Family Type Children
1 Marriage Family Childless
2 Procreation Family Children ages 0 to 2.5
3 Preschooler Family Children ages 2.5 to 6
4 School-age Family Children ages 6–13
5 Teenage Family Children ages 13–20
6 Launching Family Children begin to leave home
7 Empty Nest Family Empty nest”; adult children

have left home
Stage Theory Cont’d
• The family life cycle was used to explain the different processes that occur in
families over time.
• Sociologists view each stage as having its own structure with different challenges,
achievements, and accomplishments that transition the family from one stage to the
next. For example, the problems and challenges that a family experiences in Stage
1 as a married couple with no children are likely much different than those
experienced in Stage 5 as a married couple with teenagers.
• The success of a family can be measured by how well they adapt to these
challenges and transition into each stage.
• While sociologists use the family life cycle to study the dynamics of family over
time, consumer and marketing researchers have used it to determine what goods
and services families need as they progress through each stage (Murphy and
Staples 1979).
• As early “stage” theories have been criticized for generalizing family life and not
accounting for differences in gender, ethnicity, culture, and lifestyle, less rigid
models of the family life cycle have been developed.
• One example is the family life course, which recognizes the events that occur in
the lives of families but views them as parting terms of a fluid course rather than
in consecutive stages (Strong and DeVault 1992). This type of model accounts
for changes in family development, such as the fact that today, childbearing does
not always occur with marriage.
• It also sheds light on other shifts in the way family life is practised. Society’s
modern understanding of family rejects rigid “stage” theories and is more
accepting of new, fluid models.
• In fact, contemporary family life has not escaped the phenomenon that Zygmunt
Bauman calls fluid (or liquid) modernity, a condition of constant mobility and
change in relationships (2000).
THE INDIVIDUAL GROWING UP IN FAMILY
WITHIN SOCIETY.
• The family as a child-rearing unit of society
• Families are essentially the building blocks of society. Family units serve as the
nursery for the citizens that become the population of a society.
• In other words, families are responsible for the development of children into the
adults will later collectively be society. As each of us are influenced and formed
by our surroundings, so too is our society.
• Because society is a larger population, it may be harder to influence and change

from singular events
WITHIN SOCIETY Cont’d
• Families are so important to society because they are the foundation society is
built upon. The values of the families will be reflected in society at large.
• In all human societies the family is a primary social unit, and as an institution the
family is older than that of religion or state.
• Children are born and nurtured in the family until such time as they grow into
adults and found their own families.
• Thus, each individual has a close association with two families — the family of
birth and the family which he/she helps to found.
• At any given time, a family is composed of adults, at least two of whom live in a
sexual relationship which is socially approved, and offspring or adopted children.
• All these family members interact with each other according to prevailing social
and cultural mores as husband-wife, parent-child, brother-sister, and as groups.
• In doing so they share amenities, generate family bonds and resources and
maintain a common culture.
• In this way the family acts as an institution to satisfy biological and socio-cultural
needs such as sexual satisfaction, procreation, economic survival, child rearing
and education, and personal as well as cultural identification as participating
members of a neighbourhood or a social group.
• The pattern of interactions between family members and of family life is variable
and tends to take up the form which is most workable in meeting the basic
needs of the group under existing circumstances.
• Family life patterns vary between individual families and within the same family
group over a period of time according to external circumstances and family
crises to which adaptations have to be made.
Why Families Are Important to Society
• Why is family important? While everyone is born to a mom and dad, not
everyone is born into a loving family.
• The lack of strong, loving families can lead to a downfall of modern society in so
many ways.
• Being part of a family, or not being part of one, has a trickle-down effect on the
decisions and actions we make.
• And those decisions and actions can eventually lead to problems in society if too
many people are making poor choices that don’t benefit the group as a whole.
Why are families important to individuals and
society?
• The role of the family in society is to establish in children a sense of belonging.
• Through this primary function of the family, children can learn social skills.
• This helps them learn to interact and work together for the betterment of all.
• With this foundation of caring for themselves and others, families are also
responsible for educating children and instilling family values.
• This creates citizens that are working to reach goals in civic ways
Role of society in child development
• When it comes to impact on a child’s development, it is generally understood
that the most important role belongs to the parents.
• The role of society in child development, i.e., the impact of the environment in
which the child is growing up, is also quite significant.
• This primarily refers to the school system, where the teachers, of course,
influence the children quite a lot.
• However, teachers are only a part of a comprehensive system that affects

psychological and physical development.
Role of society in child development Cont’d
• People tend to turn to their fellow humans from the youngest age – we are
social beings and it is natural for us to maintain a high level of everyday
interaction that affects our opinions and behaviors.
• This influence is even greater in early childhood, where first social relationships
develop.
• Through the combined influences from the environment, the child develops, and
acquires social skills, which are crucial for growing up.
Factors crucial for proper child development
• The parents are the most important filter that determines how society will affect
their child.
• Although in the beginning it might seem easy to determine what is good for the
child and what is not, negative influences are impossible to avoid.
• However, a child who is growing in a positive environment will know how to

overcome the challenges of growing up.
• External influences are a part of life and the way one handles them affects the
level of success in life.
• Many things can affect a child’s development, and these are perhaps the most
important elements:
Influence of family on child development
• Without any doubt, family plays the most important role in proper child
development.
• Parents are the greatest role-models; who affect the child’s values and opinions,
the development of the child’s personality and the acquisition of good habits.
• Their effort determines whether the child’s potentials will be properly expressed,
and whether the child will be growing up happy and successful.
• Parenting styles differ from one family to another, and it cannot be said that there
is a single golden rule of upbringing.
• Of course, it goes without saying that the child needs to grow up surrounded with
love and attention.
Influence of family on child development Cont’d
• Another important role belongs to the other members of the family: siblings and
grandparents.
• Even distant relatives can affect the child a lot, because children often see them
as role-models (especially if the child finds their profession interesting).
• Adults often emphasize how a fulfilled childhood and growing up surrounded by

relatives helped them become successful people.
The Role of Family in Society
• The family is considered as the core of the society because it is the place where
its members are most personally affected.
• This is the easiest place to instill values and create change. When families
believe they can achieve and help others and lift each other up to prosper and
reach greater heights, the society can do great things.
• On the other hand, if the families are held down in an abject state of poverty
and despair, the society will not prosper.
• The impact of family on society is small when you speak of only one family.
The Role of Family in Society Cont’d
• However, it is huge when you speak of families collectively.
• And because we all influence each other in our connected communities, we can
all make a positive difference.
• The role of family in society is creating the foundational building blocks that
shape the future of our society.
• Family Set Us Up for Future Relationships
• As part of a nuclear family, children learn how to interact in an appropriate
manner to their parents and siblings.
• These are life lessons they later take out into the world and use in their
relationships with employers, friends, significant others, and even strangers.
• These familial relationships often form the basis for how people with interact
with society.
• They effect the relationships they will form as members of the community.
• Families Provide a Safe Zone
• A strong, loving family structure provides a place where children can feel safe.
• Kids will be comfortable to be who they are and know they’ll be loved and
supported. Kids have a place to go when they’re dealing with a crisis and need
help. They feel encouraged and have more confidence in themselves because
they know they’re loved and appreciated. Young people learn to give and
receive emotional support.
• When people are functioning out of a level of safety, they will make more civic
minded decisions than when they are functioning out of a level of survival. With
the support of family, individuals can succeed and accomplish greater things for
themselves and their community or country.
• Families Teach Us How to Be Part of Something
• Through family traditions, connections, and a sense of responsibility, families
teach us to love and support others.
• Families teach us not to focus solely on ourselves. Being part of a family group
teaches you how to be part of something bigger than yourself. It also teaches
you how to accept people who are different from you.
• This is a super important lesson because selfish people do not make good family
members or good members of a society.
• When they are stuck focusing solely on their own well-being, they will miss the
larger picture of how much more can be accomplished for everyone as a team.
• Good Family Relationships Are Linked to Better Mental Health
• Many studies have shown a direct correlation between family time and a child’s
mental wellbeing.
• The more time a child has with their family, the lower their risk of depression.
• Healthy family relations have a positive effect and can encourage mental
wellbeing.
• However, negative family relationships can trigger mental health issues. Close
relationships provide a stable family life that helps the child’s life feel safer and
more stable.
• Families Teach Us Values
• When children are part of a loving family that teaches discipline and family
values, they learn right from wrong and become ingrained with strong values.
These strong family values become the foundation of their identity. They’re so
much a part of who they are.
• Our values teach us how to treat other people, respect ourselves, and find our
purpose.
• For example, if in our own families we teach equality of individuals and
responsibility of individuals. These are also values that we will work to uphold in
society. Families themselves are in fact a social institution that we can chose to
value and support for our greater good. Married couples can usually offer
greater financial support and devote more time to socialization of children.
• Families Are the Strength of Our Society
• Strong families lead to strong communities and strong communities lead to a
strong society. It’s a domino effect that starts in the home and extends outward
into our communities. When we have strong family support, we are more likely
to fill our basic needs. This allows us to be stronger more productive members
for the continuation of society.
• As the International Federation for Family Development says, family is the,
“environment where ethical and cultural values are achieved in a natural way.”
Further, they state, “Taking into account the broad experience of our Federation
in dealing with families worldwide, we see every day that family is where the
vast majority of people learn the fundamental skills for life.”
Open-book Test (One Minute for each question)
1. Identify the role of genes in protein synthesis.
• a. storage of genetic information
• b. Regulation of cellular processes
• c. production of ATP
• d. Synthesis of amino acids
• 2. How do mutations in genes affect an organism?
• a. enhance overall fitness
• b. cause immediate death
• c. introduce genetic variation
• d. improve reproduction
• 3. Which of the following is a component of a chromosome?
• a. Nucleotide
• b. Gene
• c. Ribosome
• d. tRNA
• 4. Which structure in the male reproductive system carries both sperm and
urine?
• a. Epididymis
• b. Vas deferens
• c. Urethra
• d. Prostate gland
5. Explain the role of chromosomes during cell division.
a. Maintain cell shape
b. Store energy
c. Carry genetic material
d. Facilitate cell communication
6. In which phase of the cell cycle do chromosomes replicate?
a. G1 phase
b. S phase
c. G2 phase
d. M phase
7. What is the primary function of the male reproductive
system?
a. Production of eggs
b. Production of sperm
c. Menstruation
d. Hormone regulation
8. Identify the organ responsible for producing and storing
sperm in the male reproductive system.
a. Ovary
b. Uterus
c. Testes
d. Vas deferens
9. What is the main function of the uterus in the female
reproductive system?
a. Production of eggs
b. Menstruation
c. Fertilization
d. Nurturing and protecting fetus
10. How is the process of fertilization initiated in the female
a. Menstruation
b. Ovulation
c. Implantation
d. menopause
11. Which hormone is primarily responsible for regulating the
menstrual cycle in females?
a. Testosterone
b. Estrogen
c. Progesterone
d. prolactin
12. What role does the vas deferens play in the male
a. Produces sperm
b. Stores sperm
c. Transport sperm from testes to urethra
d. Releases hormones
13. Identify the structure where the fertilized egg is typically
implanted in the female reproductive system.
a. Uterus
b. Ovary
c. Fallopian tube
d. vagina
14. How does the male reproductive system regulate the
temperature for optimal sperm production?
a. Sweating
b. Contraction of scrotum
c. Vasectomy
d. Increased blood flow of testes
15. In the female reproductive system, what is the purpose of
the fallopian tubes?
a. Menstruation
b. Fertilization
c. Hormone production
d. Implantation
16. What is the significance of the prostate gland in the male
a. Produces sperm
b. Stores sperm
c. Secretes fluids to nourish sperm
d. Controls hormone levels
17. During which trimester of pregnancy does the majority of
fetal development occur?
a. First trimester
b. Second trimester
c. Third trimester
d. Pre-conception
18. What hormone is primarily responsible for maintaining
pregnancy and preventing the onset of menstruation?
a. Estrogen
b. Progesterone
c. Testosterone
d. Prolactin
19. Identify the structure that connects the developing fetus
to the uterine wall, facilitating nutrients and waste exchange.
a. Placenta
b. Amniotic sac
c. Umbilical cord
d. chorion
20. What is the process by which the cervix dilates and the
baby moves through the birth canal?
a. Contraction
b. Labour
c. Implantation
d. Ovulation
21. How does the amniotic sac contribute to the protection of
the developing fetus?
a. Provides nutrients
b. Acts as a cushion
c. Secretes hormones
d. Controls temperature
22. What is the role of oxytocin during childbirth?
a. Stimulating milk production
b. Initiating contractions
c. Regulating fetal growth
d. Preventing preterm labour
23. What is the purpose of the fontanelles in a newborn’s
skull?
a. Aid in digestion
b. Facilitate head growth during birth
c. Produce red blood cells
d. Enhance vision
24. Which stage of labour involves the delivery of the
placenta?
a. First stage
b. Second stage
c. Third stage
d. Fourth stage
25. How does the hormone prolactin contribute to the
postpartum period?
a. Inducing contractions
b. Initiating lactation
c. Preventing infections
d. Controlling blood pressure
26. What is the primary purpose of the Apgar score given to a
newborn shortly after birth?
a. Assessing maternal health
b. Evaluating fetal development
c. Measuring blood sugar levels
d. Quickly assessing the newborn’s overall health and well-
being
27. What is the primary focus during the launching stage of
the family life cycle?
a. Establishing careers
b. Raising young children
c. Nurturing adult children
d. Building a romantic relationship
28. Which term best describes the stage where a family
adjusts to the departure of grown children?
a. Launching
b. Empty nest
c. Parenthood
d. Retirement
29. During which stage does a family typically experience
increased financial pressure due to the needs of growing
children?
a. Expanding
b. Launching
c. Empty nest
d. childless
30. What is the primary goal of the childless stage in the
family life cycle?
a. Establishing careers
b. Nurturing adult children
c. Focusing on personal growth
d. Providing emotional support
CHARACTERISTICS OF ADOLESCENCE
AND BEHAVIORAL GROWTH SYNDROMES.
• Adolescence
• Adolescence, transitional phase of growth and development between
childhood and adulthood.
• The World Health Organization (WHO) defines an adolescent as any
person between ages 10 and 19.
• This age range falls within WHO’s definition of young people, which
refers to individuals between ages 10 and 24.
• In many societies, however, adolescence is narrowly equated
with puberty and the cycle of physical changes culminating in
reproductive maturity.
AND BEHAVIORAL GROWTH SYNDROMES
Cont’d
• In other societies adolescence is understood in broader terms that
encompass psychological, social, and moral terrain as well as the
strictly physical aspects of maturation.
• In these societies the term adolescence typically refers to the period
between ages 12 and 20 and is roughly equivalent to the word teens.
• During adolescence, issues of emotional (if not physical) separation
from parents arise.
• While this sense of separation is a necessary step in the establishment
of personal values, the transition to self-sufficiency forces an array of
adjustments upon many adolescents.
Cont’d
• Furthermore, teenagers seldom have clear roles of their own in
society but instead occupy an ambiguous period between childhood
and adulthood.
• These issues most often define adolescence in Western cultures, and
the response to them partly determines the nature of an individual’s
adult years.
• Also, during adolescence, the individual experiences an upsurge of
sexual feelings following the latent sexuality of childhood.
• It is during adolescence that the individual learns to control and direct
sexual urges.
Cont’d
• Some specialists find that the difficulties of adolescence have been
exaggerated and that for many adolescents the process of maturation
is largely peaceful and untroubled.
• Other specialists consider adolescence to be an intense and often

stressful developmental period characterized by specific types of
behaviour.
Physical Growth and Development in
Adolescence
• Physical changes of puberty mark the onset of adolescence (Lerner &
Steinberg, 2009).
• For both boys and girls, these changes include a growth spurt in
height, growth of pubic and underarm hair, and skin changes (e.g.,
pimples).
• Boys also experience growth in facial hair and a deepening of their
voice.
• Girls experience breast development and begin menstruating.
• These pubertal changes are driven by hormones, particularly an

increase in testosterone for boys and estrogen for girls.
Physical Growth and Development in
Adolescence cont’d
• The physical changes that occur during adolescence are greater than
those of any other time of life, with the exception of infancy.
• In some ways, however, the changes in adolescence are more

dramatic than those that occur in infancy—unlike infants, adolescents
are aware of the changes that are taking place and of what the
changes mean.
Puberty Begins
• Puberty is the period of rapid growth and sexual development that
begins in adolescence and starts at some point between ages 8 and
14.
• While the sequence of physical changes in puberty is predictable, the
onset and pace of puberty vary widely.
• Every person’s individual timetable for puberty is different and is

primarily influenced by heredity; however environmental factors—
such as diet and exercise—also exert some influence.
Puberty Begins Cont’d
• Adolescence has evolved historically, with evidence indicating that this
stage is lengthening as individuals start puberty earlier and transition
to adulthood later than in the past.
• Puberty today begins, on average, at age 10–11 years for girls and 11–
12 years for boys.
• This average age of onset has decreased gradually over time since the
19th century by 3–4 months per decade, which has been attributed to
a range of factors including better nutrition, obesity, increased father
absence, and other environmental factors (Steinberg, 2013).
Puberty Begins Cont’d
• Completion of formal education, financial independence from
parents, marriage, and parenthood have all been markers of the end
of adolescence and beginning of adulthood, and all of these
transitions happen, on average, later now than in the past.
• In fact, the prolonging of adolescence has prompted the introduction

of a new developmental period called emerging adulthood that
captures these developmental changes out of adolescence and into
adulthood, occurring from approximately ages 18 to 29 (Arnett, 2000).
Hormonal Changes
• Puberty involves distinctive physiological changes in an individual’s
height, weight, body composition, and circulatory and respiratory
systems, and during this time, both the adrenal glands and sex glands
mature.
• These changes are largely influenced by hormonal activity.
• Many hormones contribute to the beginning of puberty, but most

notably a major rush of estrogen for girls and testosterone for boys.
Hormonal Changes Cont’d
• Hormones play an organizational role (priming the body to behave in a
certain way once puberty begins) and an activation role (triggering
certain behavioral and physical changes).
• During puberty, the adolescent’s hormonal balance shifts strongly

towards an adult state; the process is triggered by the pituitary gland,
which secretes a surge of hormonal agents into the blood stream and
initiates a chain reaction.
Hormonal Changes Cont’d
• Puberty occurs over two distinct phases, and the first phase,
adrenarche, begins at 6 to 8 years of age and involves increased
production of adrenal androgens that contribute to a number of
pubertal changes—such as skeletal growth.
• The second phase of puberty, gonadarche, begins several years later

and involves increased production of hormones governing physical
and sexual maturation.
Sexual Maturation
• During puberty, primary and secondary sex characteristics develop
and mature.
• Primary sex characteristics are organs specifically needed for
reproduction—the uterus and ovaries in females and testes in males.
• Secondary sex characteristics are physical signs of sexual maturation
that do not directly involve sex organs, such as development of
breasts and hips in girls, and development of facial hair and a
deepened voice in boys.
• Both sexes experience development of pubic and underarm hair, as
well as increased development of sweat glands.
Sexual Maturation Cont’d
• The male and female gonads are activated by the surge of the
hormones discussed earlier, which puts them into a state of rapid
growth and development.
• The testes primarily release testosterone and the ovaries release

estrogen; the production of these hormones increases gradually until
sexual maturation is met.
• For girls, observable changes begin with nipple growth and pubic hair.
Then the body increases in height while fat forms particularly on the
breasts and hips.
• The first menstrual period (menarche) is followed by more growth,

which is usually completed by four years after the first menstrual
period began.
• Girls experience menarche usually around 12–13 years old.

• For boys, the usual sequence is growth of the testes, initial pubic-hair
growth, growth of the penis, first ejaculation of seminal fluid
(spermarche), appearance of facial hair, a peak growth spurt,
deepening of the voice, and final pubic-hair growth.
• Boys experience spermarche, the first ejaculation, around 13–14

years old.
Physical Growth: The Growth Spurt
• During puberty, both sexes experience a rapid increase in height and
weight (referred to as a growth spurt) over about 2-3 years resulting
from the simultaneous release of growth hormones, thyroid
hormones, and androgens.
• Males experience their growth spurt about two years later than
females.
• For girls the growth spurt begins between 8 and 13 years old (average
10-11), with adult height reached between 10 and 16 years old.
Cont’d
• Boys begin their growth spurt slightly later, usually between 10 and 16
years old (average 12-13), and reach their adult height between 13
and 17 years old.
• Both nature (i.e., genes) and nurture (e.g., nutrition, medications, and
medical conditions) can influence both height and weight.
Cont’d
• Before puberty, there are nearly no differences between males and
females in the distribution of fat and muscle.
• During puberty, males grow muscle much faster than females, and
females experience a higher increase in body fat and bones become
harder and more brittle.
• An adolescent’s heart and lungs increase in both size and capacity

during puberty; these changes contribute to increased strength and
tolerance for exercise.
Cont’d
• Stereotypes that portray adolescents as rebellious, distracted,
thoughtless, and daring are not without precedent.
• Young persons experience numerous physical and social changes,
often making it difficult for them to know how to behave.
• During puberty young bodies grow stronger and are infused with
hormones that stimulate desires appropriate to ensuring the
perpetuation of the species.
• Ultimately acting on those desires impels individuals to pursue the
tasks of earning a living and having a family.
Reactions Toward Puberty and Physical
Development
• The accelerated growth in different body parts happens at different
times, but for all adolescents it has a fairly regular sequence.
• The first places to grow are the extremities (head, hands, and feet),
followed by the arms and legs, and later the torso and shoulders.
• This non-uniform growth is one reason why an adolescent body may
seem out of proportion.
• Additionally, because rates of physical development vary widely

among teenagers, puberty can be a source of pride or
embarrassment.
Development Cont’d
• Most adolescents want nothing more than to fit in and not be
distinguished from their peers in any way, shape or form (Mendle,
2015).
• So when a child develops earlier or later than his or her peers, there
can be long-lasting effects on mental health.
• Simply put, beginning puberty earlier than peers presents great
challenges, particularly for girls.
• The picture for early-developing boys isn’t as clear, but evidence
suggests that they, too, eventually might suffer ill effects from
maturing ahead of their peers.
• The biggest challenges for boys, however, seem to be more related to
late development.
• Early maturing boys tend to be stronger, taller, and more athletic than
their later maturing peers.
• They are usually more popular, confident, and independent, but they
are also at a greater risk for substance abuse and early sexual activity
(Flannery, Rowe, & Gulley, 1993; Kaltiala-Heino, Rimpela, Rissanen, &
Rantanen, 2001).
• Additionally, more recent research found that while early-maturing
boys initially had lower levels of depression than later-maturing boys,
over time they showed signs of increased anxiety, negative self-image
and interpersonal stress. (Rudolph, Troop-Gordon, Lambert, &
Natsuaki, 2014).
• Early maturing girls may be teased or overtly admired, which can
cause them to feel self-conscious about their developing bodies.
• These girls are at increased risk of a range of psychosocial problems
including depression, substance use and early sexual behavior
(Graber, 2013).
• These girls are also at a higher risk for eating disorders, which we will
discuss in more detail later in this module (Ge, Conger, & Elder, 2001;
Graber, Lewinsohn, Seeley, & Brooks-Gunn, 1997; Striegel-Moore &
Cachelin, 1999).
• Late blooming boys and girls (i.e., they develop more slowly than their
peers) may feel self-conscious about their lack of physical
development.
• Negative feelings are particularly a problem for late maturing boys,

who are at a higher risk for depression and conflict with parents
(Graber et al., 1997) and more likely to be bullied (Pollack & Shuster,
2000).
Brain Development During Adolescence
• The human brain is not fully developed by the time a person reaches
puberty. Between the ages of 10 and 25, the brain undergoes changes that
have important implications for behavior.
• The brain reaches 90% of its adult size by the time a person is six or seven
years of age. Thus, the brain does not grow in size much during adolescence.
• However, the creases in the brain continue to become more complex until
the late teens.
• The biggest changes in the folds of the brain during this time occur in the
parts of the cortex that process cognitive and emotional information.
Brain Development During Adolescence Cont’d
• Up until puberty, brain cells continue to bloom in the frontal region.
• Some of the most developmentally significant changes in the brain occur

in the prefrontal cortex, which is involved in decision making and
cognitive control, as well as other higher cognitive functions.
• During adolescence, myelination and synaptic pruning in the prefrontal

cortex increases, improving the efficiency of information processing, and
neural connections between the prefrontal cortex and other regions of
the brain are strengthened.
• However, this growth takes time and the growth is uneven.

• The limbic system develops years ahead of the prefrontal cortex. Development in
the limbic system plays an important role in determining rewards and punishments
and processing emotional experience and social information.
• Pubertal hormones target the amygdala directly and powerful sensations become
compelling (Romeo, 2013).
• Brain scans confirm that cognitive control, revealed by fMRI studies, is not fully
developed until adulthood because the prefrontal cortex is limited in connections
and engagement (Hartley & Somerville, 2015).
• Recall that this area is responsible for judgment, impulse control, and planning, and
it is still maturing into early adulthood (Casey, Tottenham, Liston, & Durston, 2005).
• Additionally, changes in both the levels of the neurotransmitters dopamine and serotonin in
the limbic system make adolescents more emotional and more responsive to rewards and
stress.
• Dopamine is a neurotransmitter in the brain associated with pleasure and attuning to the
environment during decision-making.
• During adolescence, dopamine levels in the limbic system increase and input of dopamine
to the prefrontal cortex increases.
• The increased dopamine activity in adolescence may have implications for adolescent risk-
taking and vulnerability to boredom.
• Serotonin is involved in the regulation of mood and behavior. It affects the brain in a
different way.
• Known as the “calming chemical,” serotonin eases tension and stress. Serotonin also
puts a brake on the excitement and sometimes recklessness that dopamine can
produce.
• If there is a defect in the serotonin processing in the brain, impulsive or violent

behavior can result.
• When the overall brain chemical system is working well, it seems that these
chemicals interact to balance out extreme behaviors.
• But when stress, arousal or sensations become extreme, the adolescent brain is
flooded with impulses that overwhelm the prefrontal cortex, and as a result,
adolescents engage in increased risk-taking behaviors and emotional outbursts
possibly because the frontal lobes of their brains are still developing.
• Later in adolescence, the brain’s cognitive control centers in the prefrontal cortex
develop, increasing adolescents’ self-regulation and future orientation.
• The difference in timing of the development of these different regions of the brain
contributes to more risk taking during middle adolescence because adolescents are
motivated to seek thrills that sometimes come from risky behavior, such as reckless
driving, smoking, or drinking, and have not yet developed the cognitive control to resist
impulses or focus equally on the potential risks (Steinberg, 2008).
• One of the world’s leading experts on adolescent development, Laurence Steinberg,

likens this to engaging a powerful engine before the braking system is in place.
• The result is that adolescents are more prone to risky behaviors than are children or
adults.
Sleep in adolescents
• Brain development even affects the way teens sleep. Adolescents’ normal sleep patterns
are different from those of children and adults.
• Teens are often drowsy upon waking, tired during the day, and wakeful at night.
• Although it may seem like teens are lazy, science shows that melatonin levels (or the “sleep
hormone” levels) in the blood naturally rise later at night and fall later in the morning in
teens than in most children and adults.
• This may explain why many teens stay up late and struggle with getting up in the morning.
• Teens should get about 9-10 hours of sleep a night, but most teens don’t get enough sleep.
• A lack of sleep makes paying attention hard, increases impulsivity, and may also increase
irritability and depression.
Health Concerns During
Adolescence
• Nutrition
• Adequate adolescent nutrition is necessary for optimal growth and
development.
• Dietary choices and habits established during adolescence greatly influence
future health, yet many studies report that teens consume few fruits and
vegetables and are not receiving the calcium, iron, vitamins, or minerals
necessary for healthy development.
• One of the reasons for poor nutrition is anxiety about body image, which is a
person’s idea of how his or her body looks.
• The way adolescents feel about their bodies can affect the way they feel about
themselves as a whole.
Health Concerns During Adolescence Cont’d
• Few adolescents welcome their sudden weight increase, so they may
adjust their eating habits to lose weight.
• Adding to the rapid physical changes, they are simultaneously

bombarded by messages, and sometimes teasing, related to body
image, appearance, attractiveness, weight, and eating that they
encounter in the media, at home, and from their friends/peers (both
in person and via social media).
Health Concerns During Adolescence Cont’d
• Much research has been conducted on the psychological ramifications of body
image on adolescents.
• Modern day teenagers are exposed to more media on a daily basis than any
generation before them.
• Recent studies have indicated that the average teenager watches roughly 1500
hours of television per year, and 70% use social media multiple times a day.
• As such, modern day adolescents are exposed to many representations of ideal,
societal beauty.
• The concept of a person being unhappy with their own image or appearance has
been defined as “body dissatisfaction.”
• In teenagers, body dissatisfaction is often associated with body mass, low self-
esteem, and atypical eating patterns.
Eating Disorders
• Dissatisfaction with body image can explain why many teens, mostly
girls, eat erratically or ingest diet pills to lose weight and why boys
may take steroids to increase their muscle mass.
• Although eating disorders can occur in children and adults, they

frequently appear during the teen years or young adulthood (National
Institute of Mental Health (NIMH), 2019).
Eating Disorders
• Eating disorders affect both genders, although rates among women are
2½ times greater than among men.
• Similar to women who have eating disorders, some men also have a
distorted sense of body image, including muscle dysmorphia or an
extreme concern with becoming more muscular.
• Because of the high mortality rate, researchers are looking into the
etiology of the disorder and associated risk factors.
• Researchers are finding that eating disorders are caused by a complex

interaction of genetic, biological, behavioral, psychological, and social
factors (NIMH, 2019).
Health Consequences of Eating Disorders
• For those suffering from anorexia, health consequences include an abnormally
slow heart rate and low blood pressure, which increases the risk for heart
failure.
• Additionally, there is a reduction in bone density (osteoporosis), muscle loss

and weakness, severe dehydration, fainting, fatigue, and overall weakness.
• Anorexia nervosa has the highest mortality rate of any psychiatric disorder.
Individuals with this disorder may die from complications associated with
starvation, while others die of suicide.
• In women, suicide is much more common in those with anorexia than with
most other mental disorders.
Eating Disorders Treatment
• To treat eating disorders, getting adequate nutrition and stopping
inappropriate behaviors, such as purging, are the foundations of
treatment.
• Treatment plans are tailored to individual needs and include medical

care, nutritional counseling, medications (such as antidepressants),
and individual, group, and/or family psychotherapy (NIMH, 2019).
Sexual Development
• Developing sexually is an expected and natural part of growing into
adulthood.
• Healthy sexual development involves more than sexual behavior. It is
the combination of physical sexual maturation (puberty, age-
appropriate sexual behaviors), the formation of a positive sexual
identity, and a sense of sexual well-being (discussed more in depth
later in this module).
• During adolescence, teens strive to become comfortable with their

changing bodies and to make healthy, safe decisions about which
sexual activities, if any, they wish to engage in.
Sexual Development Cont’d
• Earlier in the physical development section, we discussed primary and secondary sex
characteristics.
• During puberty, every primary sex organ (the ovaries, uterus, penis, and testes)
increases dramatically in size and matures in function.
• During puberty, reproduction becomes possible. Simultaneously, secondary sex

characteristics develop.
• These characteristics are not required for reproduction, but they do signify
masculinity and femininity.
• At birth, boys and girls have similar body shapes, but during puberty, males widen at
the shoulders and females widen at the hips and develop breasts (examples of
secondary sex characteristics).
• Sexual development is impacted by a dynamic mixture of physical and cognitive
change coupled with social expectations.
• As the sex hormones cause biological changes, they also affect the brain
and trigger sexual thoughts.
• Culture, however, shapes actual sexual behaviors.

• Emotions regarding sexual experience, like the rest of puberty, are
strongly influenced by cultural norms regarding what is expected at
what age, with peers being the most influential.
• Simply put, the most important influence on adolescents’ sexual activity

is not their bodies, but their close friends, who have more influence
than do sex or ethnic group norms (van de Bongardt et al., 2015).
• Sexual interest and interaction are a natural part of adolescence.
Sexual fantasy and masturbation episodes increase between the ages
of 10 and 13.
• Masturbation is very ordinary—even young children have been known

to engage in this behavior.
• As the bodies of children mature, powerful sexual feelings begin to
develop, and masturbation helps release sexual tension.
• For adolescents, masturbation is a common way to explore their

erotic potential, and this behavior can continue throughout adult life.
Sexual Interactions
• Many early social interactions tend to be nonsexual—text messaging, phone calls,
email—but by the age of 12 or 13, some young people may pair off and begin
dating and experimenting with kissing, touching, and other physical contact, such
as oral sex.
• The vast majority of young adolescents are not prepared emotionally or physically
for oral sex and sexual intercourse.
• If adolescents this young do have sex, they are highly vulnerable for sexual and
emotional abuse, sexually transmitted infections (STIs), HIV, and early pregnancy.
• For STI’s in particular, adolescents are slower to recognize symptoms, tell partners,
and get medical treatment, which puts them at risk of infertility and even death.
Sexual Interactions Cont’d
• Adolescents ages 14 to 16 understand the consequences of unprotected sex
and teen parenthood, if properly taught, but cognitively they may lack the
skills to integrate this knowledge into everyday situations or consistently to
act responsibly in the heat of the moment.
• By the age of 17, many adolescents have willingly experienced sexual

intercourse.
• Teens who have early sexual intercourse report strong peer pressure as a
reason behind their decision.
• Some adolescents are just curious about sex and want to experience it.
Sexual Interactions Cont’d
• Decisions regarding sexual behavior are influenced by teens’ ability to
think and reason, their values, and their educational experience.
• Helping adolescents recognize all aspects of sexual development

encourages them to make informed and healthy decisions about
sexual matters.
Freud and Sexual Development
• According to Sigmund Freud, adolescents are in the genital stage of
psychosexual development.
• This stage begins around the time that puberty starts, and ends at
death.
• According to Freud, the genital stage is similar to the phallic stage, in
that its main concern is the genitalia; however, this concern is now
conscious.
• The genital stage comes about when the sexual and aggressive drives
have returned, but the source of sexual pleasure expands outside of
the mother and father (as in the Oedipus or Electra complex).
Freud and Sexual Development Cont’d
• During the genital stage the ego and superego have become more developed.
• This allows the individual to have a more realistic way of thinking and to
establish an assortment of social relations apart from the family.
• The genital stage is the last stage and is considered the highest level of
maturity.
• In this stage a person’s concern shifts from primary-drive gratification

(instinct) to applying secondary process-thinking to gratify desire symbolically
and intellectually by means of friendships, intimate relationships, and family
and adult responsibilities.
Social Constraints
• From a biological perspective, adolescence should be the best time of life.
• Most physical and mental functions, such as speed, strength, reaction time, and
memory, are more fully developed during the teenage years.
• Also in adolescence, new, radical, and divergent ideas can have profound impacts on
the imagination.
• Perhaps more than anything else, teenagers have a remarkable built-in resiliency,
seen in their exceptional ability to overcome crises and find something positive in
negative events.
• Studies have found that teens fully recover from bad moods in about half the time it
takes adults to do so.
• Despite this resilience, however, for some teens these years are more stressful than
rewarding—in part because of the conditions and restrictions that often accompany
this period in life.
Restrictions on physical movement
• Teenagers spend countless hours doing things they would prefer not
to do, whether it be working or spending hours behind school desks
processing information and concepts that often come across as
abstract or irrelevant.
• Even excellent students say that most of the time they are in school
they would rather be “somewhere else.”
• Many Western adolescents prefer to spend their time with friends in

settings with minimal adult supervision.
Restrictions on physical movement Cont’d
• The layouts of contemporary American communities—especially
suburban ones—cause some teens to spend as many as four hours
each day just getting to and from school, activities, work, and friends’
houses, yet getting from place to place is not something they have
control over until they obtain a driver’s license (an event that became
a major rite of passage for adolescents in much of the developed
world).
• But even with access to a car, many teenagers lack appropriate places
to go and rewarding activities in which to participate. Many engage
with digital devices or digital media or spend time with peers in their
free time.
Restrictions on physical movement Cont’d
• Adolescents generally find that activities involving physical movement
—sports, dance, and drama, for example—are among the most
pleasurable and gratifying.
• Ironically, the opportunities for participation in such activities have

dwindled, largely because budget concerns have led schools to cut
many nonacademic subjects such as physical education.
• In some public and private schools, extracurricular activities have

been greatly curtailed or no longer exist.
Isolation from adults
• Estrangement from parents has clear effects.
• Teens who do little and spend little time with their parents are likely
to be bored, uninterested, and self-centered.
• Lack of positive interaction with adults is particularly problematic in
urban settings that had once enjoyed a lively “street-corner society,”
where men traditionally shared their experiences with younger ones
in a setting that was casual and relaxed.
• This vital facet in the socialization of young men has largely
disappeared to the detriment of individual lives and communities.
• In its place, peer influence can be counterproductive by reinforcing a
sense of underachievement or sanctioning deviant behaviour.
Deviance
• With little power and little control over their lives, teens often feel that they have
marginal status and therefore may be driven to seek the respect that they feel they lack.
• Without clear roles, adolescents may establish their own pecking order and spend their
time pursuing irresponsible or deviant activities.
• For example, unwed teen motherhood is sometimes the result of a desire for attention,
respect, and control, while most gang fights and instances of juvenile homicide occur
when teenagers (boys and girls alike) feel that they have been slighted or offended by
others.
• Such deviance can take many forms.
• Insecurity and rage often lead to vandalism, juvenile delinquency, and illegal use of
drugs and alcohol. Violence and crime, of course, are as old as humankind.
Deviance
• Contemporary juvenile violence is often driven by the boredom young people
experience in a barren environment.
• Even the wealthiest suburbs with the most lavish amenities can be “barren” when
viewed from an adolescent’s perspective.
• Ironically, suburban life is meant to protect children from the dangers of the big city.
• Parents choose such locations in the hope that their children will grow up happy
and secure.
• But safety and homogeneity can be quite boring.
• When deprived of meaningful activities and responsible guidance, many teens find
that the only opportunities for “feeling alive” are stealing a car, breaking a school
window, or ingesting a mind-altering drug.
Major Characteristics of Adolescence
• A period of Rapid Physical/Biological Changes
• Appearance-Consciousness
• Impact of the Peer-Group is the Strongest
• Attraction Towards the Opposite Sex
• Cognitive Development
• Career-Consciousness
• Emotional Conditions
• Flight on Imagination
• Hero Worship
• Hobbies
• Sex-Role Identity

Family Life and Reproductive Health Education

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Family Life and Reproductive Health Education

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Family Life and Reproductive

• The term ‘reproductive health’ reflected a sharp departure from

• This inequality, rooted in societies' views of gender, plays a

• Sex refers to the anatomy of an individual's reproductive system and secondary

• Gender, on the other hand, concerns categories

• Reproductive health, therefore, implies that people are able

• They must be informed and empowered to protect themselves from

• The International Conference on Population and Development draws a clear

• Cumulatively, the denial of these rights exacerbates poverty

• Impoverished women suffer disproportionately from

• Young people are disproportionately affected by HIV, for example, and

• Adolescent reproductive health is therefore another important focus of

• Without diagnosis and treatment, some STIs, such as HIV or syphilis,

• STIs like human papillomavirus (HPV) can lead to pelvic

• UNFPA supports programmes tailored to the different challenges

• And all efforts to support sexual and reproductive health

• Ovaries in females and testicles in males are reproductive

• As in males, a variety of accessory glands releases secretions into the female

•Also, a mesovarium suspends­ each ovary in between these points.

• Anteriorly, they converge to form the hood-like covering of the clitoris.

• Huntington's disease (HD) is an inherited disorder that causes nerve cells

•There may be too many or too few chromosomes, or part of a

•These changes can cause chromosomal conditions in a baby.

• Parents can pass chromosome changes to their children, or they can

•Any condition related to genes or chromosomes can be called a genetic

•A chromosome is made of a very long strand of DNA and contains

•In addition to DNA, chromosomes contain other chemical components

• Sometimes the instructions in genes change. This is called a gene

•Protein synthesis is controlled by genes, which are contained on chromosomes.

•The phenotype is the actual structure and function of a person’s body.

•A gene consists of a sequence of bases. Sequences of three bases code for an

• Some proteins (such as hemoglobin) contain several different folded chains.

•Replication happens in a manner similar to transcription, except that the entire

• Most polymorphisms have little or no effect on the phenotype

 You have a child with a genetic condition.

• A genetic condition runs in you or your partner’s family or ethnic group. An

•Because each member of a pair of non-sex chromosomes contains one of each

•The 23rd pair is the sex chromosomes (X and Y).

•In certain ways, sex chromosomes function differently than non-sex

•Genes on the X chromosome are referred to as sex-linked, or X-linked genes.

•X inactivation occurs early in the life of the fetus.

•Because of X inactivation, the absence of one X chromosome usually results in

•Thus, missing an X chromosome is far less harmful than missing a nonsex

• For example, receiving an extra non-sex chromosome may be fatal to a fetus or

•Large areas on a chromosome may be abnormal, usually because a whole section

•For example, chronic myelogenous leukemia is sometimes caused by translocation

•This abnormality can be inherited or be the result of a new mutation.

•For example, a person's height is likely to be determined by many genes, including

•However, some traits are determined by the function of a single gene.

•Other variations, such as albinism, Marfan syndrome, and Huntington disease,

•However, not all such gene abnormalities are uniformly harmful.

•It is distinguished from genetic variability, which describes the tendency of

• In small population sizes, inbreeding, or mating between individuals with similar

•Creating or maintaining high genetic diversity is an important consideration in species

•All of these changes are triggered and maintained by hormones.

•The zygote travels through the oviduct to the uterus.

•Pregnancy tests determine the level of β-HCG in urine or serum.

•If the hormone is present, the test is positive.

•Hormonal changes often influence a woman’s emotions, particularly in the first

• Many women use a planned pregnancy as an occasion to give up smoking.

• And a number of things can be done to relieve pregnancy-related problems.

• The answer is yes, and it is usually even necessary to do so.

• In Germany, special maternity guidelines (Mutterschafts-Richtlinie) determine

• Some are also suitable if a Cesarean section needs to be performed. These

•Also, a mesovarium suspends each ovary in between these points.